Carotid Intima-Media Thickness and Cerebrovascular Disease in Community-Dwelling Older People Without Stroke

Background and Purpose-Carotid intima-media thickness (CIMT) is a noninvasive measure of atherosclerosis, but it is unclear whether it is a stronger risk factor for large vessel disease or small vessel disease. Methods-One hundred seven volunteers, aged 75 to 81 years, underwent measurements of CIMT and vascular risk factors and brain MRI (structural and diffusion tensor); those with history of stroke were excluded. Results-In 96 subjects without stroke, there were significant associations between CIMT and markers of large vessel disease (carotid stenosis: rho=0.28; P=0.01) and intermediary risk factors (systolic blood pressure: rho=0.34; P=0.001). However, there were no significant associations between CIMT and markers of small vessel disease (white matter lesion load and water diffusion parameters). Conclusions-CIMT was not associated with neuroimaging biomarkers of small vessel disease in older volunteers without stroke. Any association between CIMT and white matter lesion in previous studies is likely to be mediated via common intermediary risk factors like hypertension. (Stroke. 2010;41:2083-2086.)